Home-care workers across Manitoba say shrinking "task times" for baths, meals and medication are putting clients at risk and stressing out staff.
"We're just flying in and flying out, and it's the clients who are suffering," said one Westman home-care worker.
The Manitoba Government and General Employees Union, which represents the workers, is launching an advertising campaign today highlighting the problem of shrinking task times.
Morning care: 25 minutes.
That includes help getting out of bed, getting dressed and preparing breakfast. Five years ago, the guideline was 30 to 45 minutes, including travel time.
Bedtime care: 20 minutes.
That includes help with the toilet, brushing teeth and getting into bed. Five years ago, home-care workers had half an hour, generally, to complete the task.
Assistance with tub bath: 25 minutes. Five years ago, the task-time guideline was 45 minutes, but that typically included travel time to the client's home.
House cleaning and laundry: 2 hours. This task time has remained roughly the same, though five years ago the guideline didn't include travel time.
-- source: Home-care assignment time guideline memos, March 2006 and May 2011
The union says it's been difficult to get some regional health authorities to take the problem seriously and it's asking Manitoba Health to review the issue.
But the Winnipeg Regional Health Authority says task-time guidelines are guidelines only -- rough estimates that can be tailored to each client based on needs. WRHA officials say they've heard few complaints from clients about rushed workers.
The issue of shrinking task times is enmeshed in the move to create a stable, permanent, salaried home-care workforce province-wide. The WRHA is nearly finished its five-year process of transforming its home-care staff from casual part-time to full-time permanent, a move that's expected to shrink turnover rates and allow home-care workers guaranteed incomes. In Winnipeg, that transition is to be complete by the end of the year, but it has come with an overhaul of staff scheduling and client rosters in the city and in regional health authorities across the province.
The veteran home-care worker in western Manitoba said the workload crunch is caused, in part, by shrinking travel times between clients, which is now typically built into task times. Where workers once had 45 minutes or an hour to get a client out of bed, dressed and fed, they now have 15 minutes to half an hour, she said. Add in bad weather, poor driving conditions and a client struggling with an unexpected illness and home-care workers can be behind all day.
"It has now reached a crisis point for our clients and our workers," said the Westman worker, who did not want her name used because she could face disciplinary action for speaking publicly about her job.
She said tasks such as proper documentation and handwashing are often the first to fall by the wayside and feared more significant problems if the time crunch persists.
Another home-care worker, who also spoke on condition of anonymity, said her workload has increased significantly in the last two years and task times have shrunk. She said home-care workers are the only people many seniors see regularly, their only visitor. Spending a few extra minutes chatting, making sure medications are taken and ensuring the client is genuinely all right are key.
"I watch the clock a lot, and that's what makes me really uncomfortable," she said. "In my opinion, the care has gone out of home care."
Réal Cloutier, the Winnipeg Regional Health Authority's chief operating officer and vice-president in change of long-term and community care, said the time crunch is often a temporary problem as home care slowly transitions to a permanent workforce. In Winnipeg, that's a complex process of assigning the city's 14,000 clients, each of whom has different needs, to home-care workers, some of whom may want to remain part-time or work only six or seven hours a day. To be efficient, co-ordinators must ensure a worker has the right number of clients to fill their shift, hopefully within geographic proximity.
As each neighbourhood transitions to a full-time workforce -- Inkster and Seven Oaks are switching over now -- there are scheduling kinks, said Cloutier. But those get worked out relatively quickly and the WRHA gets few complaints from clients once it's done.
"If we were cutting services to clients, we would hear about it," he said.
He said staff who feel they cannot complete a task in the allotted time can call their co-ordinators to rejig their schedule.
"We wouldn't be doing our job if we didn't have some guidelines, but those aren't hard and fast," he said. "We use them for planning guidelines... But if a bath can be done in 20 minutes, it will be done in 20 minutes. If it takes an hour, it takes an hour."
The MGEU's ad campaign launches today, beginning with radio commercials.